Total hip arthroplasty in acetabular deficiency: experience in Al Razi Hospital, Kuwait.

Objective: To report clinical and radiological outcomes of cemented and cementless total hip arthroplasty for primary and secondary osteoarthritis with a deficiency of acetabular bone stock.

Subject And Methods: Thirty-seven patients (16 male and 21 female) having 41 hips affected by primary and secondary acetabular bone stock defect that were operated using cemented (n = 25) and cementless (n = 16) hip replacement were followed for an average period of 37 (range 12-100) months. Bone defect was classified according to American Academy of Orthopedic Surgery criteria. Different types of bone graft techniques and metal reinforcements were used. Merle d'Aubigné clinical score was used to calculate clinical outcomes. Geometrical position of the acetabular component, cup integration, hip center and graft integration were assessed.

Results: The mean clinical score improved significantly from 10.6 patients preoperatively to 16.7 patients postoperatively; 95% of the cups were in the desired position and were considered integrated and the bone graft remodeled in most cases. There were 2 deep infections, 1 dislocation and 2 cases of transient neurological deficit. No significant differences in final clinical and radiological outcomes, rate of loosening and rate of complications were found between cemented and cementless acetabular replacements.

Conclusion: The results show that reconstruction of acetabular bone deficiency can be accomplished with few complications using either a cemented or cementless acetabular component with or without grafting according to the clinical situation.